Mike Miliard

U.S. Federal Trade Commission said that the cloud-based electronic health record vendor misled patients into sharing sensitive medical without knowing it could be posted in a public-facing provider directory.  

The confluence of new care models and technology are enabling data scientists to pinpoint gaps in access to care, address social determinants of health, and map data that informs tactics to improve outcomes at the patient and population level.

Stakeholders have until June 27 to weigh in with the Centers for Medicare and Medicaid Services. Why should you? Experts say the Medicare Access and CHIP Reauthorization Act is an aggressive and transformational piece of rulemaking. 

Examining electronic health record data over a 10-year period from Geisinger Health System shows socioeconomic factors have an impact on adverse effects of overdoses.

Nicholas Marko, MD breaks down the differences between big data analytics and business intelligence, and explains how Geisinger chooses between centralizing and federating data.

Chief Data Officer, Nicholas Marko, MD, outlines three strategies that have helped Geisinger become a large scale data-centric organization.  

Geisinger Chief Data Officer Nicholas Marko, MD, says deriving value from data depends on a sound roadmap. Here’s a look at how to determine what you need to get there.

CHIME has named two winners of the "Concept Blitz Round" of the National Patient ID Challenge it launched with HeroX, selected from an initial round of eight finalists. A panel of five independent judges first narrowed the initial 113 entrants down to 23 semifinalists and then eight finalists. Of those, Michael Braithwaite, who has devised a scalable strategy that uses enhanced biometric information to match patients with their unique health data, and Mark Schroeder, who proposes to deploy HL7-approved standards to enable demographics and biometrics for patient ID – came out on top. Both won $30,000. The other six finalists were: Shawnnah Castillo; Kathryn Elaine; Bon Sy and Ayman Zeidan; and teams from Mathematica Policy Research, Spiral Nebula and RightPatient. Launched in January, the CHIME/HeroX challenge seeks innovative ways to help U.S. providers reliably, accurately, privately and safely identify patients. Speaking at HIMSS16 in Las Vegas this March, CHIME Board Chair Marc Probst, CIO at Intermountain Healthcare, called the lack of a dependable patient ID a "vexing problem" for healthcare with adverse effects on cost, efficiency, quality and safety. "Done right, a national patient ID will save lives," he said. [Also: ONC awards Boston Children's Hospital $275,000 to work on EHR apps discovery site] In a June 1 press statement, Probst said he was encouraged and excited by some of the innovative projects submitted to the Concept Blitz Round, with so many leveraging technology that already exists and won’t require wholesale disruption of today’s IT systems. That's critical to finding a tool that can be deployed across healthcare organizations of varying sizes and providers types, he said. "As patients increasingly seek care across the continuum, and data moves from one care setting to another, it is vital that we ensure patients are accurately identified and matched to their records." The patient ID challenge now moves into the Final Innovation Round – open from June 1 to November 10. Innovators were not required to take part in the Concept Blitz Round in order to enter the final round, but must register by July 12 to be eligible for the $1 million prize. With Johns Hopkins recently pointing to medical errors as the third leading cause of death in the U.S., the stakes are higher than ever for accurate patient matching, CHIME CEO Russ Branzell said in a statement. "We know that somewhere, right now, a patient is being harmed due to misidentification," he said. "We owe it to our patients to solve this problem once and for all. The solutions coming forward in this challenge are pointing us to a real solution." Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

Half of hospitals routinely use patient information received electronically from other providers, which National Coordinator Karen DeSalvo, MD said is an indication of how far the healthcare industry has come for both patients and clinicians.

By Michelle Andrews, Kaiser Health News In his recent book, “The Finest Traditions of My Calling,” Dr. Abraham Nussbaum, 41, makes the case that doctors and patients alike are being shortchanged by current medical practices that emphasize population-based standards of care rather than individual patient needs and experiences. Nussbaum, a psychiatrist, is the chief education officer at Denver Health Medical Center and practices on the adult inpatient psychiatric unit there. I recently spoke with him and this is an edited transcript of our conversation. Q. Your book is in some ways a lament for times gone by, when physicians were “artisans” who had more time for their patients and professional independence. But you’re a young doctor and you must have known at the outset that wasn’t the way medicine worked anymore. Why do you stick with it? A. The first thing I’d say was that I didn’t know right away that medicine is no longer universally understood as a calling instead of a job. We are describing health as if it is just another consumer good, and physicians and other health practitioners as the providers of those goods. That is the language of a job. When you remember that being with the ill is a calling, then you remember that it is a tremendous privilege to be a physician. People trust you with their secrets, their fears and their hopes. They allow you to ask about their lives and to assess their bodies. So my lament is not for the loss of physician privilege — goodbye to that — but to the understanding of medicine as a calling. Q. You don’t like checklists and quality improvement measures that dictate how physicians care for patients because you say it turns doctors into technicians and is an obstacle to “moral reasoning.” But those tools, which generally take a systems approach to providing care and rely on evidence-based guidelines, aren’t going away anytime soon. How do you do the kind of doctoring you want to do in this environment? A. Quality improvement seems to be here to stay. Regulators at all levels require it. But I believe that evidence of its success is not as clear as they suggest. Just last week, the British Medical Journal published a study that found no evidence that introducing quality metrics has resulted in a significant reduction in patient mortality. The leaders of the quality movement’s version of quality improvement developed out of industrial engineering, so they are always comparing the care of patients to things like the production of cars or the flying of airplanes. People are far more varied than cars on assembly line or planes on the runway. So quality metrics always feel forced to me, especially for the more interactive medical encounters. In my own specialty, the current quality metrics all encourage me to perform standardized screens on patients or to document carefully. None of them require me to develop a relationship with a patient so that I can, say, foster hope after a suicide attempt, or knit a psychotic person back into the life of their family. Yet that it was my patients want, those human relationships. It is also what physicians want, and the most recent studies suggest that most physicians are dispirited by quality metrics. Q. But not all physicians are equally skilled or conscientious. As a patient, I feel more comfortable knowing there are rules and standards that doctors have to meet. A. I don’t think physicians should be free to do whatever they want. Their thinking and decision-making should be held up to scrutiny. A physician’s standard of quality should be evidence-based, but even more, it should be patient-centered. The standard should be what the patient defines as what matters. So if you are suffering chronic pain, it is not just a reduction of your score on a standardized pain scale, but your ability to resume the activities you identify as constitutive of your life. Q. You talk about wanting to be able to sit with patients and talk with them, to really “see” them. All that takes time that physicians don’t generally have. I understand your book isn’t a how-to manual. But, really, how can physicians do this, even if they want to? A. It’s a real challenge. It’s important to use the time you have in service of the patient’s needs. I don’t review records while I’m in the room with a patient. I try to make every question be about the patient. I have to ask standard questions, but I try to do that as way to get to know the patient. For example, if I have to ask questions about what they can remember, I’d ask about a book they have with them. Part of my concern about checklists is that they train you to follow a script instead of following your patients. Q. Only 55 percent of psychiatrists take insurance compared with nearly 90 percent of physicians in other specialties. That puts their services out of financial reach for many people who could use their help. How does that square with your vision of doctors as healers and teachers? A. It’s deeply concerning to me. I’ve made a conscious choice to work at a safety net hospital, so I can see people regardless of their ability to pay. I hope that through things like the Medicaid expansion and mental health parity, more psychiatrists will work with people who have mental illness. Q. You talk about the virtues of “slow” medicine, similar to the slow food movement, where physicians reject providing care in a standardized, mass-produced fashion. One path that some physicians have chosen is to establish boutique practices that accept a limited number of patients who pay extra fees for more personal attention and better access. What’s your perspective on that? A. It sounds appealing to me. In most descriptions of boutique medicine, they talk about it like a lovely restaurant, one that I couldn’t afford to go to every night. I think it’s an interesting model but not a solution to the large problems facing medicine, in particular the ability to provide care to the most needy among us and the indigent. This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.